1. Field of the Invention
The invention is a surgical device used in the field of ophthalmology, which allows penetrating or lamellar cornea transplant surgery to be performed without the use of suture.
2. Description of Related Art
Cornea transplantation is a complex procedure, which is currently done by joining the central portion of a cornea from a donor with the peripheral portion of the cornea of the recipient. The cornea transplantation process is very important for the resolution of many diseases that affect significant parts of the world population, including the loss of transparency of the cornea, or the modification of the cornea's curvature which induces abnormalities in the projection of light to the retina and consequent visual limitation.
In cornea transplantation, the setting, capping, and cooptation between the donor tissue and recipient tissue is crucial to achieving a satisfactory optical and functional outcome after surgery. Currently, the procedure is performed through a mechanical trephination, with a button of cornea tissue being excised from the cornea recipient. A button of cornea tissue is also excised from the cornea donor by trephination. The button of cornea tissue has a circular format, and the diameter can vary depending on the purpose of the surgery. After adequate preparation of the donor tissue, which can be done in an artificial anterior chamber to facilitate handling, the donated cornea is then placed in the same position where the cornea was trephinated from the recipient patient. After positioning and smoothing the donor cornea, sutures are made with yarn of a small size, usually Nylon 10-0, separated in the vast majority of cases, in order to obtain the best possible junction between the recipient and donor tissue.
For that to occur, it is essential that a proper trephination of both corneas be performed, particularly when the trephinations are made by different types of mechanical trephination. There can be no openings between the donor and recipient tissue, in order to prevent the leakage of aqueous humor which is present in the anterior chamber of the eye. In order to correctly seal, the suture points must be tight. However, this induces large abnormalities in the format of previous surface of the cornea, which eventually causes significant astigmatism.
With the advent of the incorporation of femtosecond laser technology in medical practice, particularly in ophthalmology, new opportunities for preparation of cuts in the cornea are being proposed. The possibility currently exists of conducting the trephination in both the cornea recipient and the cornea donor in a more complex way, with precise incisions in the vertical and horizontal planes, and with strong tangential cuts to the surface of the cornea. The depths of these cuts can be established and the planned in sync between the tissue donor and recipient, increasing the precision of the procedure.